If you think you are affected by Autoimmune Hypophysitis, see your primary care provider. they will be able to determine if your symptoms are related to this disease. A good history and a general examination are usually sufficient to make a diagnosis. Asking you about the symptoms, their eventual relation with a pregnancy and, your positive history for other autoimmune diseases, they can suggest exams you can take to confirm the diagnosis. He can also identify the best kind of specialist you need. At this time, only general examination can be performed, testing inflammatory parameters (VES, PCR, and others) or general function of vital organs (basic hematological assays).

The endocrinologist is the specialist who can best understand whether your symptoms (bitemporal hemianopsia and headache for example) may be related to a pituitary problem. A physical examination, with more attention to endocrine glands and their targets, such as breast and thyroid, can confirm this diagnosis. The endocrinologist can also suggest which kind of hormonal examination you should have, to check if your pituitary is working properly. At this time only the basic functions of thyroid, adrenal, gonads and eventually GH (in children) need to be checked. Finally, in concert with your medical practitioner, your endocrinologist can identify some autoimmune markers (other organ-specific autoantibodies), that could be positive, especially when autoimmune hypophysitis is associated with other autoimmune disease.

When the diagnosis has been confirmed you need to come back to your endocrinologist, to decide if it is necessary to completely test the pituitary function, if you need a specific therapy or if you need follow-up only.

Your ophthalmologist is the best doctor to diagnose bitemporal emianopsia. They can differentiate between the visual defects deriving from pituitary compression on the optic chiasma, and those caused by retinal problems, which are not related with pituitary enlargement. The field of vision examination is a easy exam which tests the sensitivity of your optic tract. When the optic chiasma is compressed in the middle, the visual field is defective in its peripheral parts: the retinal sensitivity decreases because of the compressive effect of the gland enlargement.

It is best if your primary care provider, together with your endocrinologist and your ophthalmologist, talk together to decide the strategy in choosing the best imaging approach. Usually, all of them, agree on the fact that MRI represents the most sensitive and specific way to confirm a pituitary enlargement. Speaking with the radiologist, will help your primary care provider to be more aware of radiological signs that can predict an autoimmune disease. In fact, the role of the radiologist is the most difficult, because sometimes he can not differentiate between an inflammatory enlargement or a pituitary tumor.